Research overview

My interests include clinical research and public health. Specific areas involve measures of visual function in visual system disorders. In particular, I am interested in the investigation of age-related macular degeneration (AMD), in terms of monitoring the progression of visual loss, using functional and imaging techniques. Recent studies have evaluated the use of microperimetry with a focus on clinical interpretation with respect to normative data. Current work includes the assessment of the relationship between vision-related quality of life outcomes with clinical measures such as microperimetry, in AMD and an evaluation of the role of microperimetry in nystagmus. I am also interested in public health research in individuals with low vision. Recent projects have examined the outcomes of vision rehabiliation.

Teaching overview

My teaching duties include the role of module leader for the "Ocular Pharmacology" module for the second year undergraduate students. I am responsible for organising the course, designing the structure of the course and writing and delivering the lectures and practical sessions. I also supervise in the second year undergraduate "Investigative Techniques Clinics".

My research interests involve the examination of visual function in age-related macular degeneration (AMD), which was established during my PhD and developed during international postdoctoral research fellowships.

Past work involved the topographical assessment of the retina using multimodal imaging in relation to visual function measured by microperimetry and other visual field techniques in AMD and in other retinal diseases. Recent studies have evaluated the application of normative data in microperimetry, using the Macular Integrity Assessment (Centervue; Figure 1) and MP-1 (Nidek) instruments, to enable robust interpretation of results in those with visual system disorders. A current study is the evaluation of the relationship of microperimetry with vision-related and health-related quality of life instruments in individuals with AMD.

In other research, we have estimated the impact of vision rehabilitation on quality of life outcomes in individuals with low vision. Our findings provide support for the effectiveness of the vision rehabilitation service.

Commercial microperimetry is limited by the lack of robust probability analyses. A normative database and robust model of analysis to detect abnormality have been developed.

Despite similarities in stimuli and threshold procedures between microperimetry and conventional perimetry, there are important differences between instruments that need to be taken into account when interpreting visual field results. These include the difference in dynamic range, normative data and background luminance levels. The amount of visual loss detected, differed between instruments and this was dependent upon adaptation level and type of retinal disease.

Vision rehabilitation has a positive influence on vision-related quality of life.

Funding

John R (PI), Acton JH, £16,636, Evidencing the potential role of Low Vision Service Wales Optometrists in the certification of vision impairment, Sight Cymru 2017